Phosphate induced crystal acute kidney injury – an under-recognized cause of acute kidney injury potentially leading to chronic kidney disease: case report and review of the literature

Abstract

S Lochy,1 R Jacobs,1 PM Honoré,1 E De Waele,1 O Joannes-Boyau,2 J De Regt,1 V Van Gorp,1 HD Spapen1 1Intensive Care Dept, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; 2Haut Leveque University Hospital of Bordeaux, University of Bordeaux 2, Pessac, France Abstract: Acute phosphate nephropathy or nephrocalcinosis is a tubulointerstitial nephropathy characterized by tubular calcium phosphate deposition – crystal nephropathy – and slowly progressive renal insufficiency during or following treatment with preparations containing sodium phosphate. We report a patient who developed nephrocalcinosis (crystal induced acute kidney injury) following the administration of a combination of oral and rectal sodium phosphate for treatment of postoperative constipation. A timely renal replacement therapy procedure may reverse the process of crystallization and the irreversible slope towards chronic dialysis. Keywords: hemofiltration, acute phosphate nephropathy, hyperphosphatemie, crystal induced nephropathy, CRRT, worse prognosis, dialysis